‘We want to be part of the hospital staff. This course will open doors for us. Hospitals will see it as a serious profession once there is a degree [in the field].’Laughter is the best medicine – an old saying, but one that the University of Haifa is taking seriously by introducing Israel’s first degree program – and perhaps the only degree in the world – in medical clowning.

“It’s a kind of start-up actually,” said Herzel Ziyoni about the pilot program being offered by the university’s Department. of Theater.

Ziyoni is one of the 19 students in the special, one-year BA degree program, all of whom already practice medical clowning. They belong to a group of 36 medical clowns who call themselves “Dream Doctors.” The group, set up four years ago by the Keren Magi Foundation, is now a fixture in 16 Israeli hospitals from Nahariya to Beersheva. The foundation is also paying these students’ tuition.

Though the hospitals accept the presence of medical clowns, they don’t consider them part of the staff. The students hope that the new degree program will change this situation.

“We use clowning in the different hospital departments to further patient care. It’s not just a performance,” says Renana Lotem Ophir, who studied acting in Israel and London before becoming a Dream Doctor. “We want to be part of the hospital staff. This course will open doors for us. Hospitals will see it as a serious profession once there is a degree [in the field].”

Ophir pointed out that the Dream Doctors work in the hospitals in the morning, when the doctors make their rounds. “Everywhere else in the world, they [clowns in hospitals] perform in the afternoon, when visitors are present. We work in the morning, to be part of the treatment.”

Ziyoni, who has studied acting at New York’s Neighborhood Playhouse, was eager for what he described as the “academization of the field” of medical clowning. He welcomed this opportunity, he said, to complete his education with courses in different areas of the caring profession. “Medical clowning,” he told ISRAEL21c, “was a whole process. We build a fantasy world, but it’s not just to make them, the patients, happy and then we leave.”

Sounding anything but clownish, he continued: “Clowning enables us to open up avenues of communication with patients that the medical staff doesn’t succeed with or doesn’t know how to connect with. We create experiences, we create distractions, so the patient won’t feel his or her pain and can fly with us to fantasy lands. Or allow a kid to undergo a CT without the need for an injection or pill to first calm him down.”

Ziyoni does much of his clowning work in the oncology and dialysis units. Dr. Atay Citron, chairman of the University of Haifa Theater Department, believes the program will teach medical clowns “things you don’t learn in acting school, like the relationship between caregiver and patient or the psychological state of a patient in pain.

“They [the students in the program] have already studied the profession of clowning. We want to expand their understanding in the realm of theater and in the field of nursing. This program will create better medical clowns,” he sums up.

In addition to courses in the Theater Department and in the Faculty of Social Welfare and Health Studies, the medical clowning program will have special offerings. One of these, found nowhere else in Israel, is the Sociology of Humor and Clowning.

The course instructor will be Associate Professor Yoram Carmeli, a Haifa University sociologist who has perhaps the perfect credentials for this assignment: he himself has performed as a clown under the big top. His course, he says, will be based on both academic research and practical experience.

The comic figure of the doctor is part of Commedia del ‘Arte theater, Carmeli points out, adding that there are also precedents in the shaman and medicine man, with their circus-like performances. Then, too, therapy through acting and therapy and humor are well known, not just in theater, but also in psychotherapy, he notes. “So there is a tradition to all this.”

Carmeli thinks students in the program should not just be clowns and, when performing, not seek public applause. “They should have compassion. They should care about the patients, have interaction with them,” he says.

“Medical clowns have to deal with children, with adults, with people from different cultures and different senses of humor. This adds to the difficulty of trying to turn a situation into something humorous,” the sociologist emphasizes.

He hopes future students will come both from the world of clowning and from the caregiving professions. “The more backgrounds there are, the more ideas are produced to help patients,” he advises.

Although Carmeli acknowledges that intuition is an important attribute for clowning, he thinks it might be better for medical clowns to have health care experience before deciding to be clowns.

Ziyoni and Ophir disagree. The students think clowning should be the basis.

“It’s an instinct,” Ziyoni says. “To break barriers like clowning does is more difficult than learning something technical.” Ophir, too, feels that “hospital work” can be learned there and that a medical clown should have clowning experience first.

Both students think Haifa University’s degree program will help gain the field recognition as a profession. The Health Ministry would then make it a regular hospital position, they believe, and hospitals would hire medical clowns on a salaried basis. Right now, the Magi Foundation supports the Dream Doctors financially.

The members of the Dream Doctors group usually work one on one – one clown to one patient. Renana Ophir perhaps sums up the wonderful utility of medical clowning when she says, “Great things happen between two pairs of eyes and one large red nose.”